NESCSO helps State agencies improve the effectiveness of publicly funded health and human services by investing in State employees

NESCSO helps State agencies improve the effectiveness of publicly funded health and human services by investing in State employees

All Payer
NESCSO’s The New England States’ All-Payer Report on Primary Care Payments Receives National Association of Health Data Organizations’ Award for Innovation in Data Dissemination
Milbank & NESCSO Blog -More Information Needed: How CMS Can Best Partner with State Medicaid Agencies
More Information Needed: How CMS Can Best Partner with State Medicaid Agencies
State Medicaid
State Medicaid Agency Interoperability Survey
Effective Medicaid White Paper

Vermont Agency of Human Services Leadership Academy

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About NESCSO

The New England States Consortium Systems Organization NESCSO is a non-profit organization governed by the New England State Health and Human Services agencies and the University of Massachusetts Medical School.

New England Member States

NESCSO connects New England HHS staff with opportunities to learn from peers in neighboring states and colleagues within their state. Our learning communities and academies allow New England HHS staff to collaborate with their in-state colleagues and regional peers to tackle the problems they face.

National Work

Through the Medicaid Enterprise Systems Community (MESC) and the Systems Technical Advisory Group (S-TAG), NESCSO keeps the people responsible for state Medicaid systems in communication with both federal and state peers about the challenges they face. NESCSO also offers multi-state demonstrations of new technology, multi-state procurement, and model contract language.

LATEST EVENTS

NESCSO Activities

Connect with the MES Community

The Medicaid Enterprise Systems Community (MESC) is comprised of thought leaders from the public and private sectors who share ideas and information related to Medicaid systems and initiatives. Each year, this community gathers together at the annual MESC national conference to build upon each other’s experiences and work to improve the health care and lives of members.

Learning Communities

 

  1. Learning Community Name: Pharmacy Learning Community
  2. Learning Community Lead: Bonnie Greenwood, PharmD, BCPS; Clinical Program Director – Clinical Pharmacy Services, Commonwealth Medicine and Assistant Professor – Department of Family Medicine and Community Health, UMass Chan Medical School
  3. Participating States: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
  4. Purpose of Learning Community: To support peer relationships across the States, to discuss and learn from issues impacting States, and to identify regional initiatives that will positively impact States’ programs.
  5. Recent Activities Completed and Planned for 2022:
      • In 2022, the Pharmacy Learning Community is planning to release a Request For Information to assess the feasibility of engaging a vendor to survey specialty pharmacies to obtain specialty drug acquisition costs. States are interested in understanding if there is savings potential to be realized from changing current reimbursement methodologies for specialty drugs to one based on actual acquisition cost.
      • In 2022, we will also develop a number if issue briefs on topics of interest to Medicaid Pharmacy Directors such as digital therapeutics, payment for pharmacist cognitive services, and high-cost pharmaceuticals. The purpose of these issue briefs is to provide succinct, actionable information tailored to the Medicaid perspective.
      • Four of the six New England states are participating in an Agency for Healthcare Research and Quality-funded research study led by UMass Chan Medical School. This is a four-year mixed methods study to: (1) track trends in uptake of direct-acting antiviral regimens for the treatment of hepatitis C virus in four New England states’ Medicaid populations, (2) identify factors that predict treatment and (3) understand barriers and facilitators for treatment in this population.
      • In 2019, NESCSO’s Executive Director and Pharmacy Learning Community Lead published a white paper to provide Medicaid Directors and State Agency Personnel guidance on components of an effective Medicaid pharmacy program.
      • Over the past couple of years, the Pharmacy Learning Community has engaged with a number of influential guest speakers from organizations such as the Centers for Medicare and Medicaid Services, Institute for Clinical and Economic Review, Patients for Affordable Drugs, The National Academy for State Health Policy, Dana Farber Cancer Institute, and brooklyn46.

 

  1. Learning Community Name: New England Medicaid Quality Collaborative
  2. Learning Community Lead: Joshua Slen
  3. Participating States: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
  4. Purpose of Learning Community:  This community focuses on the measures state Medicaid agencies use to determine the quality of care provided through Medicaid and the effectiveness of program initiatives. Broadly this includes considerations that drive value-based care and population health and impact how programs are designed, implemented, operated, and measured.
  5. Recent Activities Completed and Planned for 2022:
      • In 2021, we reviewed, discussed, and provided formal comments to CMS regarding the 2022 Child and Adult Core Set Review Workgroup Draft Report.
      • In 2022, we are focusing on the following:
        • Outcome Based Certification (OBC): We hosted a presentation on how Vermont has successfully used OBC on a recent technology procurement, dramatically reducing their level of effort needed to receive full federal funding.
        • Social Determinants of Health (SDOH) and Health Equity quality measures. We began in 2021 with a discussion and survey of use of SDOH measures by the NE states. In late 2021 and early 2022 we hosted presentations on SDOH measure use and design by the Centers for Health Care Strategy and the Gravity Project. In 2022 we will explore the topic further, learning from other states on how SDOH measures are used
        • Use of Health Information Exchange (HIE) for quality measure reporting: What is the process? Are any states doing this successfully? With what measures?
        • Long Term Services and Supports (LTSS) quality reporting: What does CMS require? What measures are available? What are other states doing?
        • Review, discuss and comment on the 2023 Child and Adult Core Set Review
        • Medicaid and CHIP (MAC) quality rating system (QRS): How states are preparing to implement a MAC QRS in anticipation of federal requirements.
  1. Learning Community Name: Pharmacy Learning Community
  2. Learning Community Lead: Bonnie Greenwood, PharmD, BCPS; Clinical Program Director – Clinical Pharmacy Services, Commonwealth Medicine and Assistant Professor – Department of Family Medicine and Community Health, UMass Chan Medical School
  3. Participating States: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
  4. Purpose of Learning Community: To support peer relationships across the States, to discuss and learn from issues impacting States, and to identify regional initiatives that will positively impact States’ programs.
  5. Recent Activities Completed and Planned for 2022:
      • In 2022, the Pharmacy Learning Community is planning to release a Request For Information to assess the feasibility of engaging a vendor to survey specialty pharmacies to obtain specialty drug acquisition costs. States are interested in understanding if there is savings potential to be realized from changing current reimbursement methodologies for specialty drugs to one based on actual acquisition cost.
      • In 2022, we will also develop a number if issue briefs on topics of interest to Medicaid Pharmacy Directors such as digital therapeutics, payment for pharmacist cognitive services, and high-cost pharmaceuticals. The purpose of these issue briefs is to provide succinct, actionable information tailored to the Medicaid perspective.
      • Four of the six New England states are participating in an Agency for Healthcare Research and Quality-funded research study led by UMass Chan Medical School. This is a four-year mixed methods study to: (1) track trends in uptake of direct-acting antiviral regimens for the treatment of hepatitis C virus in four New England states’ Medicaid populations, (2) identify factors that predict treatment and (3) understand barriers and facilitators for treatment in this population.
      • In 2019, NESCSO’s Executive Director and Pharmacy Learning Community Lead published a white paper to provide Medicaid Directors and State Agency Personnel guidance on components of an effective Medicaid pharmacy program.
      • Over the past couple of years, the Pharmacy Learning Community has engaged with a number of influential guest speakers from organizations such as the Centers for Medicare and Medicaid Services, Institute for Clinical and Economic Review, Patients for Affordable Drugs, The National Academy for State Health Policy, Dana Farber Cancer Institute, and brooklyn46.
  1. Learning Community Name: New England Medicaid Quality Collaborative
  2. Learning Community Lead: Joshua Slen
  3. Participating States: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
  4. Purpose of Learning Community:  This community focuses on the measures state Medicaid agencies use to determine the quality of care provided through Medicaid and the effectiveness of program initiatives. Broadly this includes considerations that drive value-based care and population health and impact how programs are designed, implemented, operated, and measured.
  5. Recent Activities Completed and Planned for 2022:
      • In 2021, we reviewed, discussed, and provided formal comments to CMS regarding the 2022 Child and Adult Core Set Review Workgroup Draft Report.
      • In 2022, we are focusing on the following:
        • Outcome Based Certification (OBC): We hosted a presentation on how Vermont has successfully used OBC on a recent technology procurement, dramatically reducing their level of effort needed to receive full federal funding.
        • Social Determinants of Health (SDOH) and Health Equity quality measures. We began in 2021 with a discussion and survey of use of SDOH measures by the NE states. In late 2021 and early 2022 we hosted presentations on SDOH measure use and design by the Centers for Health Care Strategy and the Gravity Project. In 2022 we will explore the topic further, learning from other states on how SDOH measures are used
        • Use of Health Information Exchange (HIE) for quality measure reporting: What is the process? Are any states doing this successfully? With what measures?
        • Long Term Services and Supports (LTSS) quality reporting: What does CMS require? What measures are available? What are other states doing?
        • Review, discuss and comment on the 2023 Child and Adult Core Set Review
        • Medicaid and CHIP (MAC) quality rating system (QRS): How states are preparing to implement a MAC QRS in anticipation of federal requirements.

Contact

Get In Touch

Have questions? We want to hear from you!